Browsing by Author "Trinh, Jane V"

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    Can this patient read and understand written health information?
    (JAMA, 2010-07) Powers, Benjamin J; Trinh, Jane V; Bosworth, Hayden B

    Context

    Patients with limited literacy are at higher risk for poor health outcomes; however, physicians' perceptions are inaccurate for identifying these patients.

    Objective

    To systematically review the accuracy of brief instruments for identifying patients with limited literacy.

    Data sources

    Search of the English-language literature from 1969 through February 2010 using PubMed, Psychinfo, and bibliographies of selected manuscripts for articles on health literacy, numeracy, reading ability, and reading skill.

    Study selection

    Prospective studies including adult patients 18 years or older that evaluated a brief instrument for identifying limited literacy in a health care setting compared with an accepted literacy reference standard.

    Data extraction

    Studies were evaluated independently by 2 reviewers who each abstracted information and assigned an overall quality rating. Disagreements were adjudicated by a third reviewer.

    Data synthesis

    Ten studies using 6 different instruments met inclusion criteria. Among multi-item measures, the Newest Vital Sign (English) performed moderately well for identifying limited literacy based on 3 studies. Among the single-item questions, asking about a patient's use of a surrogate reader, confidence filling out medical forms, and self-rated reading ability performed moderately well in identifying patients with inadequate or marginal literacy. Asking a patient, "How confident are you in filling out medical forms by yourself?" is associated with a summary likelihood ratio (LR) for limited literacy of 5.0 (95% confidence interval [CI], 3.8-6.4) for an answer of "a little confident" or "not at all confident"; a summary LR of 2.2 (95% CI, 1.5-3.3) for "somewhat confident"; and a summary LR of 0.44 (95% CI, 0.24-0.82) for "quite a bit" or "extremely confident."

    Conclusion

    Several single-item questions, including use of a surrogate reader and confidence with medical forms, were moderately effective for quickly identifying patients with limited literacy.
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    Caring for Each Other: A Resident-Led Peer Debriefing Skills Workshop.
    (Journal of graduate medical education, 2023-04) Lee, Grace S; Dizon, Samantha E; Feeney, Colby D; Lee, Yu-Lin Amy; Jordan, Megan; Galanos, Anthony N; Trinh, Jane V

    Background

    Inadequate time and space to process critical incidents contribute to burnout. Residents do not regularly participate in emotional debriefs. An institutional needs assessment revealed only 11% of surveyed pediatrics and combined medicine-pediatrics residents had participated in a debrief.

    Objective

    The primary objective was to increase resident comfort in participation in peer debriefs after critical incidents from 30% to 50% with implementation of a resident-led peer debriefing skills workshop. Secondary objectives included increasing resident likelihood of leading debriefs and comfort in identifying symptoms of emotional distress.

    Methods

    Internal medicine, pediatrics, and medicine-pediatrics residents were surveyed for baseline participation in debriefs and comfort in leading peer debriefs. Two senior residents became trained debrief facilitators and led a 50-minute peer debriefing skills workshop for co-residents. Pre- and post-workshop surveys assessed participant comfort in and likelihood of leading peer debriefs. Surveys distributed 6 months post-workshop assessed resident debrief participation. We implemented the Model for Improvement from 2019 to 2022.

    Results

    Forty-six (77%) and 44 (73%) of the 60 participants completed the pre- and post-workshop surveys. Post-workshop, residents' reported comfort in leading debriefs increased from 30% to 91%. The likelihood of leading a debrief increased from 51% to 91%. Ninety-five percent (42 of 44) agreed that formal training in debriefing is beneficial. Almost 50% (24 of 52) of surveyed residents preferred to debrief with a peer. Six months post-workshop, 22% (15 of 68) of surveyed residents had led a peer debrief.

    Conclusions

    Many residents prefer to debrief with a peer after critical incidents that cause emotional distress. Resident-led workshops can improve resident comfort in peer debriefing.